Implementing Isometrics: From Rehab to Sports Performance

To weeks ago our blog delved into the different muscle contraction types. 

With this knowledge  in mind, what do you think pause squats, a plank, and a wall sit have in common? If you said that all three involve an isometric muscle contraction, you are correct!

What are “Isos”? 

Isometric training, often referred to as “isos” in the coaching + rehab world, is a type of static muscle action that we experience hundreds of times per day. Carrying the groceries inside on your forearm? This is an isometric bicep contraction. For a quick rundown on contraction types, take a look at this blog. (Part 1)

Iso means same. Metric means measure. So an isometric exercise  is simply a contraction where the muscle is contracting but there is no change in the length of the muscle or the range of motion in the surrounding joints. Tension is generated within the surrounding muscles and tendons, but no dynamic motion occurs. 

What and Who are Isometrics Good For? 

Isometrics can be a good entry point for PT and in the weightroom, but they can serve as so much more than that. The positive effects of isometric exercises are vast, and if you’re looking for a deep dive on it, check out this 2019 review. Here is a (by no means exhaustive) list of a few of the times we may implement isometrics here at Made 2 Move: 

• Entry point for rehab

• When there is a load, ROM, or velocity intolerance, isometrics can be used to dial back the intensity until the body is ready to reintroduce the full movement again. For example, if a basketball player is experiencing knee pain when squatting in the weightroom, we can load them heavy isometrically in a quarter squat, increasing the load and/or depth until full range squats become tolerable again. 

• The stork exercise is another \ great isometric exercise often used to promote single-leg strength and stability in rehab. 

• Gain stability in a range before incorporating movement through that range

• In the presence of injury, static movements are often done before dynamic movements when re-introducing previously painful exercises. An example of this would be someone with shoulder pain overhead. A static hold with a DB overhead (isometric) may be done before progressing back to dynamic movements (pressing,  snatches, throwing). 

• Measurement

• Isometric movements, like the seated knee extension, are often used here at Made 2 Move in order to track force production ACL surgery. 

• Stated perfectly in this 2023 article,  “Assessment systems should be specific enough to isolate and track independent attributes while also minimizing redundant information” (James et al. 2023). Isometric force measurements can do just this. 

• Motor Coordination and Relearning

• After surgery or injury, muscles often dial back their activation, likely secondary to complex pain mechanisms. Isometric holds can be used to retrain these motor patterns and encourage adequate muscle firing. 

• Natural analgesic, particularly for tendinopathies

• Research, although conducted on a very small cohort, (6 participants), demonstrated that isometric exercises decreased knee pain in those with patellofemoral knee pain for at least 45 minutes post-isometric contraction (Rio et al. 2015). If pain is a limiting factor to movement, incorporating isometrics at the beginning of a session can help “open the window” for patients to be able to perform dynamic movements in a more tolerable manner. 

• A 2015 study found that, “five repetitions of 45-second isometric quadriceps exercises on a leg extension machine induces analgesia for several hours in patients with PT. A Spanish squat with 70- 90 degree knee flexion angle with the support of a rigid strap fixating at the lower leg can be an alternative way when there is a limited access to gym equipment” (Rio et al. 2015). 

• Strength and hypertrophy

• Isometrics can, in their simplest form, be used in the gym to strengthen challenging positions and grow your muscles. This could look like pause squats for a lifter at their “sticking point.” For hypertrophy, aim for longer holds, while for challenging positions and max strength, shoot for short (1-10 seconds), higher intensity holds. 

• Promote Proper Positioning 

• Isometrics can help promote positioning required for skilled movements. For example, a gymnast working on handstands could hold a hollow body position before their handstands in order to promote the rigid, stacked position required to execute a free standing handstand.

• Mobility Gains

• Isometrics can be used to load challenging ranges of motion in order to promote mobility gains through them. For example, an athlete struggling with front squats due to a lack of thoracic mobility can work on isometrically holding a heavy barbell in this position prior to executing the full front squat. 

• Increase Intensity + Time Under Tension

• Isometrics can be added to a dynamic movement in order to increase the overall time under tension. An example of this would be your pause squats or bench. 

• Sport specific positions

• This could look like HEAVY quarter squat holds for swimmers or sprinters to mimic the start out of blocks. 

• Another option is a sprinter hip thrust hold. This is similar to the bridge exercise, which often gets a bad rap in physical therapy for being too low level. But if this exercise is loaded adequately and in the positions similar to those experienced in your sport, it can be a valuable driver of adaptation!

Different Ways to Tweak Isometrics: 

With isometrics, any tweaks that are made essentially come down to 3 principles: joint angle, intensity, and intent (Oranchuk et al. 2019).

1. Joint angle → the muscle length chosen for isometrics affects outcomes + the difficulty of an exercise due to muscles having biomechanically optimal lengths at which they can fire most efficiently. Manipulating joint angles may look like our Crossfitter holding a squat at different angles dependent upon their “sticking points” or our athlete who underwent ACL surgery working knee extension at different angles dependent upon their pain thresholds. 

2. Intensity or duration →How HARD or how LONG are you holding or pushing? For example, if doing an isometric mid thigh pull (IMTP), you can pull harder against the rack to⬆️ the intensity. You could also hold the pull for 10 seconds instead of 5 seconds, as long as you are able to maintain the desired intensity throughout. 

3. Intent  → Every exercise should have intent, but intent in this context refers to specific variations in isometrics, encompassing concepts like ramp and ballistic actions. This is typically a variable only manipulated in the research or sports world, when coaches are looking to drive very specific adaptations. 

Here at Made 2 Move…

Manipulating joint angle and intensity are the most common variables we dial into in in the rehab and performance world here at Made 2 Move. Intent is more commonly used in the sports or research setting when minute changes in force production matter. But for the general population, adjusting intent gets slightly into the weeds and is less relevant to overall pain reduction and function. 

Isometrics can be used for all of the above and they are just a tool, not the end all be all. Do you enjoy them? Are they translating well to what you’re trying to accomplish? Let’s use them! If not, there are other ways to gain the desired adaptations. Interested in working with a PT who will adjust your training based your goals and current supporting research? Reach out to frontdesk@made2movept.com today to set up an appointment with a PT at any of our 4 locations!